Medical Test in Health Insurance & Its Importance

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Written by PolicyBazaar

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Modified 23 November 2017

Most people generally loathe the idea of having to undergo medical tests and examinations. There have been many incidences where people shun the idea of investing in a particular insurance, if the insurance company urges them to undergo certain medical tests before approval.

A fair share of people also fall prey to false advertisements run by many insurance companies where they promise to provide health insurance without a medical test. Somehow the possibility of not having to undergo a medical test, just to buy a term plan, seems much favorable. But, are health insurance policies without medical tests worth it? Does it pose a problem later and create a sticky situation that you can do nothing about?

Let’s first understand how beneficial it is, if you opt for an insurance policy without a pre-medical requirement.

Below are a few assumptions.

Policy approval time is quicker in case of health insurance without medical tests.

The one seeking the policy saves time, as they don’t have to travel to the predefined medical centre.

If the policyholder suffers from an existing medical condition, not having to undergo a medical test would mean that they do not have to pay a higher premium on insurance.

Why do Insurance Companies Insist on a Pre-Medical Test before Policy Approval?

Generally the onus of checking the risk potential of the policyholder rests with the underwriting team. By asking you to do a medical test or checkup, the insurance company eliminates the task of their underwriting teams, which is not the case for health insurance without medical tests.

If an insurance company offers medical test at discounted rates, there are high chances that they could charge you a higher premium on your policy. This is because the premium payment is based on the perceived health risk that the policyholder is supposedly exposed to. In case there are certain tests missing, it is assumed that the policyholder is trying to hide certain medical conditions, and hence is charged a higher premium rate.

On hindsight, if you do a complete medical test as stated by the insurance company, there is possibility you only pay a “Preferred Rate” if your tests determine you are healthy. Opting for health insurance without medical tests would mean that you would attract the following rates predefined by most insurance companies.

Standard Rate

Sub Standard Rate

Smoker Rate

“Preferred Rate” is a lower premium rate offered to the policyholder who is deemed healthy through medical checkups and tests as requested by the insurance company and not applicable in case you buy health insurance without medical tests.

Buying an insurance policy that does not require medical tests done could mean that you undertake a “Declaration of Good Health.” With this statement especially as a policyholder, the disclosure onus lies on you. In times of medical insurance requirement, if it is found that you have an existing medical issue not disclosed, your policy claim can be rejected on grounds of the “nondisclosure of medical facts.”

By not disclosing medical, “Material facts” about you, the insurer has no decision power to insure you. There has, however, been a slight change in this since Oct 2015, especially for claims made on a policy existing for over 3 years. In such cases, the insurer has to pay the claim made by the insured.

When you apply for an insurance policy the underwriting team checks your risk factors as well as your Human Life Value. The amount is calculated on your financial and medical underwriting. If your policy is devoid of these processes, there is a chance that your life cover is not of the value you want.

The deducted amount means that you are under insured, something that no policyholder would like, especially in times when they are in dire need of financial support. This again points to the fact that getting a medical test done is necessary to fend off any chances of being under insured.

A low risk cover would even disregard the fact that you are young and very healthy; the only cover you might receive is just Rs.5 Lakh cover. If the policyholder does a medical test and duly submits medical test results, they stand chances of receiving a higher cover as per their requisites.

A snapshot of your health result is, therefore, essential for you as a policyholder and the insurance company. For the policyholder, it allows for lesser chances of rejection on claim of policy, and getting a reasonable risk cover.

Final Verdict

The verdict is in favour of medical tests that most insurance companies ask you to undergo. Health insurance policies without medical tests attract a higher premium amount. It is, therefore, advisable to thoroughly evaluate non-medical test polices, before you buy them. Buy them only if they suit your needs, preferences and budget.

We suggest you choose a policy that wants you to undergo medical tests, instead of health insurance without medical tests. The tests are nominally charged, and a full report includes fasting blood sugar, blood pressure test, blood count, ECG and sometimes it could also include liver tests and kidney tests. The tests are not much of a hassle and will only help you in the long run.

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*The information provided on this website/page is only for information sake. Policybazaar does not in any form or manner endorse the information so provided on the website and strives to provide factual and unbiased information to customers to assist in making informed insurance choices.